DEPARTMENT OF HEALTH AND HUMAN SERVICES

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1 DEPARTMENT OF HEALTH AND HUMAN SERVICES COUNTY OF MARIN Larry Meredith, Ph.D., Director DIVISION OF PUBLIC HEALTH COMMUNITY HEALTH & PREVENTION SERVICES Marin HIV/AIDS Care Council Meeting 899 NORTHGATE DRIVE, SUITE 415 MINUTES SAN RAFAEL, CA May 14, 2008 PHONE: (415) (Approved 6/11/08) FAX: (415) :30p.m. - 6:30p.m. 899 Northgate Drive - 4 th Floor Conference Room San Rafael, CA Council Members Present: Roy Bateman, Will Boemer, Kevin Cronin, Wade Flores, James Frazier, Peter Hansen, Walter Kelley, Jennifer Malone, Craig Richard, David Witt Council Members Absent: Jeff Byers, (AE), Pam Lynott (LOA) Staff Present: Cicily Emerson, Deborah Gallagher, Chris Santini, Sparkie Spaeth, (Michael Schieble absent) Public: Jon Botson (Marin County Specialty Clinic), Robert Ferguson, Robert Vargas (Marin Treatment Center), Cynthia McIntyre (Hospice by the Bay) I. Call to Order Meeting called to order at 4:33 pm by Co-Chair Flores. II. III. Roll Call Roll was called by Council Support and quorum was established with 10 of 12 members present*. CM Byers (AE) was absent and excused. CM Lynott is on a Leave on Absence (effective 03/04/08). (*CM Witt arrived late 5PM) CM Boemer welcomed the 2 new Council members: Craig Richard and Kevin Cronin. Each Council member introduced him/herself and stated how long he/she has been on the Council. Review and Approval of Agenda VOTE The Agenda was reviewed. CM Boemer stated that Item XII should be moved ahead of Item XI. CM Frazier motioned to approve the revised agenda. CM Hansen seconded. A voice vote was conducted. All were in favor. None were opposed. The Agenda was approved unanimously. IV. Review and Approval of April 9, 2008 Minutes VOTE The Minutes of April 9, 2008 were reviewed. CM Malone motioned to approve. CM Kelley seconded. A voice vote was conducted. CM Bateman abstained. All others were in favor. None were opposed. The Minutes were approved. V. General Announcements CM Boemer: The upcoming MAP retreat for gay and bi men will be held 6/13-6/15/08 at Wildwood Retreat Center near Guerneville. Sparkie Spaeth: The Specialty Clinic has officially moved to the new Health & Wellness Campus (3270 Kerner, Ste B). It is in a temporary location on the Campus until the rest of the integrated clinic moves in October. CM Flores: Food for Thought in Sonoma will have a Gay Pride Parade in June. Contact Spectrum if you want to join their contingency to carry the flag. Public Comment: NONE VI. Public Comment - NONE 1

2 VII. VIII. Welcome of new Council Members CM Boemer again welcomed the new members and acknowledged the Public present. Co-Chair Report CM Boemer had nothing to report, except budget items discussed later in agenda. IX. Membership Committee Report CM Hansen stated that the Committee reviewed attendance, reported on recruitment plans, reviewed applications, discussed orientation and committee assignments for new members, discussed/distilled exit interview questions, and discussed personal introduction format. There are two applications pending. They will look at demographics to help recruit new members. X. Community Outreach and Advocacy Report CM Witt reported that there was no quorum, so no meeting was held in April. The Committee is hoping to get a forum together in the Spring. Planning for the forum will be done at the next COA meeting at 5:30 PM on 5/22/08 at Marin AIDS Project. XI. Conflict of Interest Review/Discussion Cicily Emerson presented a PowerPoint about the Conflict of Interest Policy [see ATTACHMENT1]. Each Council member discussed his/her perceived or actual conflict of interest. CM Cronin and CM Malone have actual conflicts of interest (both employed by service provider, Marin AIDS Project) and all others have perceived conflicts of interest. Conflict of interest is enforced by Co-chairs. Conflicts should be disclosed before speaking at meetings. Those with actual conflicts of interest must recuse themselves when voting on services provided by the agency they work for. XII. Review 08/09 Budget - VOTE Cicily Emerson reported that the budget has been increased from $677,137 to $847,408, which is about a 25% increase. She passed out a spread sheet showing all the services, rankings, and allocations that were voted on last July. [see ATTACHMENT 2] The County recommends taking 2.4% off the top for Council support, making a flat (23%) increase across all items, and taking any unused money from residential substance abuse treatment and reallocating it for pharmaceuticals on a quarterly basis. After discussion by the Council, CM Frazier motioned to approve 2.4% for Council Support. CM Hansen seconded. VOTE: Witt Boemer Flores Kelley Hansen Malone Richard Cronin Frazier Bateman Y Y Y Y Y RECUSE ABSTAIN RECUSE Y RECUSE The motion to take 2.4% off the top for Council Support carries. CM Witt motioned to approve taking $2238 from residential substance abuse treatment and move it to food and to examine the actual expenditures/unspent funds in September. CM Kelley seconded. VOTE: Witt Boemer Flores Kelley Hansen Malone Richard Cronin Frazier Bateman Y Y Y Y Y RECUSE Y RECUSE Y Y The motion to take $2238 from residential substance abuse treatment and move it to food passed. 2

3 CM Witt motioned to approve increasing the rest of the categories by 23%. CM Cronin seconded. VOTE: Witt Boemer Flores Kelley Hansen Malone Richard Cronin Frazier Bateman Y Y N Y Y RECUSE Y RECUSE N Y The motion to approve increasing the rest by 23% passed. CM Witt motioned to move any unspent residential substance abuse treatment to pharmaceuticals or transportation assistance. CM Kelley seconded. VOTE: Witt Boemer Flores Kelley Hansen Malone Richard Cronin Frazier Bateman Y Y Y Y Y RECUSE Y RECUSE Y Y The motion to move any unspent residential substance abuse treatment to pharmaceuticals or transportation assistance passed. XIII. XIV. XV. Division of Public Health Report Chris Santini reported on satisfaction survey results from women who received CARE services last year. [see ATTACHMENT 3] Next Step New Business Prepare for July prioritization and allocation Cicily suggested having a Project Independence presentation Meeting Adjourned at 6:30p.m. 3

4 What is a Conflict of Interest? Conflict of Interest Review Marin County HIV/AIDS Care Council May 14 th 2008 Conflict of Interest may be defined as an interest by a Council member in an action that may result in personal, organizational, or professional gain or give the appearance of such gain. In Plain English An employee, board members or consultant who works for an agency that receives funding for HIV/AIDS Services has a Conflict of Interest in voting on those same services since they may benefit from the outcome. All Council members Agree To separate themselves from any actual or perceived special interests during Council deliberations. To act only on behalf of the broadly affected HIV community in its totality. Signed on the Conflict of Interest Disclosure form What does Unaffiliated Mean? Unaffiliated refers to consumers who have no conflict of interest, meaning they have no financial or governing interest in Title I-funded agencies. Consumers who volunteer with a Title I-funded provider are not considered to "represent" that entity and are unaffiliated members. Perceived Conflict vs. Conflict Council members who are unaffiliated may opt to disclose a perceived conflict of interest on this form in an effort to establish full transparency. What are your perceived or actual conflicts? 4 1

5 Policy Overview Policy Overview Adopted December of 2005 Council member conflicts will appear on their name card at the council table Enforced by the Co-Chairs When voting on individual or grouped service categories, all Council members with a conflicts of interest shall recuse themselves from voting. It is the responsibility of the Council Co-Chairs to enforce this policy during council meetings. Policy Overview Specific to Discussion Members with an actual or perceived conflict may engage in the discussion but they must disclose this conflict during the discussion. I have a conflict of interest regarding XX service. However, I would like to offer this opinion Policy Overview, Specific to Voting All Council Members with a conflict shall recuse themselves from voting on issues that relate to an action which may result or appear to result in personal or professional gain. Vote or NO Vote Vote or NO Vote Joyce is a unaffiliated consumer. She gets food cards through the County food program. The Council is considering reducing the food allocation Does Joyce VOTE? Max is a manager at the County Clinic which receives title I funds to provide direct services. The Council is considering and increase to one of the services that is provided at the Clinic Does Max VOTE? 5 2

6 Vote of NO Vote Final note Jeremiah is client at the County Medical Clinic but also works as a client advocate at Horizon Services who receives title 1 funding for case management The council is considering decreasing case management funding Recusal will reduce the quorum Abstention counts as a no vote Does Jeremiah VOTE? 6 3

7 08/09 Allocation % of Ryan White Funding in Marin County Voted on by the Marin HIV/AIDS CARE Council on 07/25/07 08/09 Award amount= $847,408 After 2.4 % (20, 500) Administrative Deduction= $ 826,908 A B C D E F G H Core Services Priority Rank 08/09 Funding Allocations % of Total Award Allocated Adjusted % Proposed 08/09 Allocation With State Rollover Increase 07/08 Spent Outpatient /Ambulatory health services 1 138, % 20.50% 169, , ,789 Mental health services g 2 82, % 12.19% 100, ,800 75,836 (including Treatment Adherence) 4 182, % 26.99% 223, , ,892 Home health care (nursing) y 5 50, % 7.42% 61,357 71,357 80,000 Health Services (attendant care) 5 inc inc inc inc inc inc. Substance abuse services outpatient 6 15, % 2.22% 18,357 18,357 37,736 Oral health care g y 7 32, % 4.82% 39,857 39,857 42,662 Pharmaceutical Assistance (local) 8 8, % 1.19% 9,840 9,840 16,392 Support Services Case Management (non- Medical) 3 90, % 13.35% 110, , ,851 Residential substance abuse treatment 6 10, % 1.48% 12,238 12,238 - Direct Emergency financial assistance 8 20, % 2.97% 24,559 32,682 13,308 Food bank/home-delivered meals(vouchers) 9 40, % 6.05% 50,028 57,332 49,225 Direct Emergency Financial - Transportation Medical 10 5, % 0.82% 6,781 18,904 4,000 Food bank/home-delivered meals(vitamins) 11cluded in Food Inc. Inc. Inc. Inc. Inc. Other-Council Support 15 3, % TOTALS $677, % % 826, , CORE Services TOTAL 75% $507, ,910 Support Services TOTAL 25% $169, , 998 7

8 ATTACHMENT 3 INFORMATION ON WOMEN RESPONDENTS TO 2008 SATISFACTION SURVEY Number of women mailed 2008 survey=24 Number of women who completed 2008 survey=12 Response rate for women=50% Response rate for all respondents=42.5% Percentage of survey respondents who are women=17% Percentage of CARE database clients (March-August, 2007) who are women=15.5% Percentages of Living AIDS cases (as of April, 2008) who are women=11.4% Percentage of Living HIV cases (as of April, 2008) who are women=10.7% 8